OPERATIONS 



903 



OPERATIONS 



uded strips on either side are wider and nearer 

 The tongue of the posterior vaginal wall 

 ected up and brought forward over the median 

 stitched between the labia and lateral walls, 

 the perineum is united by deep external sutures 

 ing behind. Bishop's [Stanmore] : I. For the 

 / cure of inguinal hernia ; a modification of 

 t's operation in which the thread is passed 

 through the wall of the sac on each side, so that when 

 drawn upon, the sac is thrown into folds like a purse ; 

 Bishop also cuts open the anterior wall of the inguinal 

 canal. 2. For suture of the intestine: an interrupted shoe- 

 maker's stitch is introduced on the mucous aspect, each 

 suture loop being tied on alternate sides of the line of 

 junction. Blandin's : I. F 'or deviated nasal septum ; the 

 removal of discs from the septum by means of a special 

 punch. 2. For double harelip : repression of the pre-max- 

 illary bone after excision of a wedge-shaped piece of the 

 vomerine plate immediately behind it. 3. For exci- 

 sion of the upper jaw ; it is done by a median incision. 

 The cheek nap is raised by means of two incisions — 

 the first carried down from the inner canthus along the 

 side of the nose and into the mouth through the median 

 line of the lip ; the other is carried along the lower 

 margin of the orbit. 4. For symblepharon ; dissec- 

 tion from above downward, and folding inward of the 

 flap to form the palpebral conjunctiva. Blasius' : 

 I. For blepharoplasty ; a flap is taken from the fore- 

 head to form a lower eyelid. 2. For chiloplasty ; 

 two curved incisions are made, each beginning at 

 the center of the lower lip and extending outward and 

 downward to the sides of the cheeks, for the purpose 

 of forming a lower lip. 3. For uranoplasty ; a flap 

 is dissected from the forehead, and the long pedicle is 

 twisted so that the flap (the nose being absent) can be 

 brought through the nares into the cleft. Bobbs' 

 . for cholecystotomy ; the gall-bladder is incised 

 and, after removal of calculi, is closed by one suture. 

 Boeckel's (£ ) ■ l. For the removal of tumors of the 

 naso-pharynx : an incision is made down to the bone 

 across the bridge of the nose, from one lacrymal sac to 

 the other, and is carried down one nasal furrow to the 

 margin of the nostril, which it opens. The columna 

 is also separated ; the bones in the line of the incision 

 ire divided, and the septum is separated and the tumor 

 removed ; the parts are then to be restored. 2. For ex- 

 :ision of the wrist; it is done by a single dorsal incision 

 an the radial side, with division of the extensor tendons 

 }n the same side, and ending by the subperiosteal 

 operation. Boen's, a method of performing embry- 

 it consists in the removal of all of the pro- 

 apsed portions of the fetus, followed by thoracic and 

 lbdominal evisceration, complete division of the fetus 

 nto two parts and separate extraction of the two. 

 Bogue's, for varicocele ; ligation with catgut of the 

 ."eins at different points, after exposing them by means 

 )f an incision. Bohm's, for tenotomy ; it is the 

 method of performing tenotomy. Bond's, 

 f oot ; it consists in making two transverse and 

 it wo semicircular incisions across the side of the foot 

 1 vith a Paquelin cautery, beginning at the inner malle- 

 l extending one-third of the distance across 

 of the foot, the semicircular incisions crossing 

 he transverse. The contraction following healing is 

 aid to restore the arch. Bonnet's (.)/. A.): 1. For 

 i nucleation of the eye : the conjunctiva is divided at the 

 orneal border, and separated from the ball for some 

 hstance back ; the tendons are next cut, and pressure 

 ackward on the lids will usually dislocate the ball 

 arward. when it may be grasped and the enucleation 

 ompleted. 2. For the radical cure of hernia : after 

 eduction of the hernia, a fold of skin is tucked up. 



and three or four needles are passed through and 

 allowed to remain ; these set up inflammation, which 

 closes the canal. The spermatic cord must be avoided. 

 Bonzel's, for iridodialysis ; the iris is detached with 

 a small hook through a corneal incision. Borelli's, 

 for staphyloma ; the staphyloma is transfixed with two 

 pins introduced at right angles to each other, and en- 

 circled behind the pins with a thread. Bose's, for 

 tracheotomy ; a vertical incision is made in the middle 

 line for about one-and-a-half or two inches from the 

 center of the thyroid cartilage ; a transverse incision 

 is then made along the upper border of the cricoid 

 cartilage to divide the deep cervical fascia. Bos- 

 worth's, for deviated nasal septum; removal of the 

 obstructing tissue by means of a delicate saw. Bot- 

 rel's, for the removal of naso-pharyngeal tumors ; in 

 order to preserve the free border of the soft palate, 

 Maisonneuve' s incision is made, followed by Xelaton s 

 operation. Bottini's (£.), for enlarged prostate 

 gland; a fresh urethra is bored through the substance 

 of the gland by means of the galvano-cautery. 

 Bouisson's (/".), for rhinoplasty ; this is very similar 

 to Thiersch's operation, but the flaps are formed 

 somewhat differently. Boutonniere : I. For exter- 

 nal urethrotomy ; the stricture is divided through an 

 opening made in the urethra just beyond it. 2. For 

 the removal of nasal polypi ; extraction through an 

 incision in the middle line of the soft palate. Bow- 

 man's : I. For conical cornea ; a circular portion 

 of the apex is removed with a small trephine which 

 is not allowed to penetrate the whole thickness of the 

 cornea. 2. For discission ; two needles are passed 

 through the cornea at the same time, one near the inner 

 and the other near the outer margin. The points of the 

 needles are plunged into the center of the membrane 

 and drawn apart by sweeping movements. 3. For 

 ectropion ; The same as -'. Amnion's operation. 4. For 

 excision of the pupil ; the puncture and counter-punc- 

 ture are made with Graefe's linear knife ; the blades of 

 fine scissors are introduced and a triangular piece of 

 the iris, as well as the constrictor pupillx, removed. 5- 

 For fistula of the lacrymal gland ; the establishment 

 by means of a thread of a fistula on the conjunctival 

 surface, to permit of the opening in the skin being 

 permanently closed. 6. For iridodesis ; radial incision 

 of the iris from the pupillary margin. 7. For lacry- 

 mal obstruction ; slitting of the canaliculi. 8. For 

 ptosis ; subcutaneous division of the tarsal portion of 

 the orbicular muscle. Boyer's, for excision of the 

 tongue ; it is done through the mouth by two converg- 

 ing incisions and two lateral ones, meeting at the 

 same point. Bozeman's (.V. ), for vesico-vaginal fis- 

 tula : the edges of the fistula are pared and wire sutures 

 are introduced in the usual manner, after which a lead 

 plate or " button " is threaded on the sutures so as to 

 cover the fistula. It is held in place by perforated shot. 

 Brainard's : I. For angular ankylosis of the knee; 

 the shaft of the femur is drilled subcutaneously and 

 then fractured. 2. For ectropion; a flap-transplant- 

 ing operation. 3. For ununited fracture ; drilling of 

 the fragments to excite reparative action. Brandt's, 

 for uranoplasty ; in cases of a wide cleft and a deep 

 palate, all the molars of the upper jaw are extracted 

 some months before the operation to produce flattening 

 of the palatal arch. Brasdor's, for aneurysm ; ligation 

 immediately beyond the aneurysm. Braun's, for ne- 

 phrectomy ; it is done by means of a transverse incision 

 eight or ten cm. long, parallel with and one cm. below 

 the arch of the ribs. Bribosia's, for cataract ; the 

 knife is passed across the anterior chamber and the iris 

 is caused to prolapse upon the knife as the incision is 

 made, so that iridectomy is simultaneously performed, 



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